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Home My WebLink AboutInsurance Letter - Correspondence - 16 HALIFAX STREET 9/8/2023 GEICO Insurance Agency, LLC Underwritten By: l-lomesite Insurance Company HomesiteTel: 1-800-566-1518 110IVI r: I N,I)R A N O: Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 68269002 NN RP 14 20230914 NNNNNNNN Ooo4410 0016 Claim Number: 01-006-687201 NORTH ANDOVER TOWN HALL Date of toss; 09/08/2023 120 MAIN ST Policy Number; 37379132 NORTH ANDOVER, MA 01845-2420 Policyholder; Martin Kelly And Mary Kelly IIIII-IIi[IIIIiI1111111 it]I II III IIIIIII1IIIII11111 September 13 2023 ATTENTION: Building Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or Board of Selectmen CIO City or Town Hall NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 3113 Our Insured: MARTIN KELLY Property Address: 16 Halifax St North Andover, MA, 01845-4231 Policy Number: 37379132 Claim Number: 01-006-687201 Date of Loss 09/08/2023 This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section 3B, a claim has been made involving loss, damage or destruction to a building or other structure which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice pursuant to Massachusetts General Laws Chapter 139, Section 3B is appropriate, please direct such notice to my attention and kindly, pursuant to the information provided above, include the insured's name, address, policy number, claim number and date of loss. If you contact us via email, please use claimdocuments@afics.com and be sure to reference the claim number in the subject line of your email. Please contact me with any questions. Sincerely, / ate? Rawi Marquise Rush Claims TPA Property Independent Adjuster AFICS on behalf of Homesite Insurance Company Marquise.Rush @afics.com Phone-, 1-254-271-3079 1 Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 Page 1 of 1 02VO)J NN RP 14202J?}141JNNNNNIWOd }"100015 73%,175-ohl u4-10,3-3-6b*)7h4^W 1412